Trial reportTrials2011
Reducing the environmental impact of trials: a comparison of the carbon footprint of the CRASH-1 and CRASH-2 clinical trials.
Trial report in Trials, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- The Role of Virtual Consulting in Developing Environmentally Sustainable Health Care: Systematic Literature Review.Journal of medical Internet research · 2023Pooled it
- Trial
- Measuring the carbon footprint of clinical research activities: a scoping review of measurement tools and methods.BMJ open · 2026Article
- Article
- Evaluating the Environmental Impact of Clinical Research: A Full Life Cycle Analysis of a French Academic Randomised Clinical Trial.Fundamental & clinical pharmacology · 2026Article
- Assessing the carbon footprint of French academic clinical trials using the NIHR method.BMJ open · 2025Article
- Targeted complement inhibition ameliorates the pathological and cognitive outcomes in repetitive mild closed head injury.Signal transduction and targeted therapy · 2025Article
- Reimagining Social Value to Consider the Environment: How Should We Judge the Magnitude of Benefits in Health Research?Bioethics · 2025Article
- Stepping Stones to Sustainability Within Cancer Clinical Trials in Ireland.Current oncology (Toronto, Ont.) · 2025Article
- Carbon footprint of a sample of clinical trials for people with neurological disorders: cross-sectional analysis.BMJ open · 2025Article
- Integrating Sustainability Pillars Into Trial Design Decision-Making: Results of an International Survey.Clinical and translational science · 2025Article
- Viewpoint: a white paper for a greener design, conduct and reporting of clinical trials in respiratory medicine.The European respiratory journal · 2025Article
- Imperatives and co-benefits of research into climate change and neurological disease.Nature reviews. Neurology · 2025Review
- Article
- (Un)Sustainable Science: Greening Practices in Research, Clinical Microbiology, and Veterinary Laboratories Locally and Globally.Open forum infectious diseases · 2025Review
- What is the carbon footprint of academic clinical trials? A study of hotspots in 10 trials.BMJ open · 2024Article
- An urgent call for environmental accountability in nephrology clinical trials.Clinical kidney journal · 2024Article
- Defending and Defining Environmental Responsibilities for the Health Research Sector.Science and engineering ethics · 2024Article
- The relevance of sustainable laboratory practices.RSC sustainability · 2024Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAll sectors of the economy, including the health research sector, must reduce their carbon emissions. The UK National Institute for Health Research has recently prepared guidelines on how to minimize the carbon footprint of research. We compare the carbon emissions from two international clinical trials in order to identify where emissions reductions can be made.
methodsWe conducted a carbon audit of two clinical trials (the CRASH-1 and CRASH-2 trials), quantifying the carbon dioxide emissions produced over a one-year audit period. Carbon emissions arising from the coordination centre, freight delivery, trial-related travel and commuting were calculated and compared.
resultsThe total emissions in carbon dioxide equivalents during the one-year audit period were 181.3 tonnes for CRASH-1 and 108.2 tonnes for CRASH-2. In total, CRASH-1 emitted 924.6 tonnes of carbon dioxide equivalents compared with 508.5 tonnes for CRASH-2. The CRASH-1 trial recruited 10,008 patients over 5.1 years, corresponding to 92 kg of carbon dioxide per randomized patient. The CRASH-2 trial recruited 20,211 patients over 4.7 years, corresponding to 25 kg of carbon dioxide per randomized patient. The largest contributor to emissions in CRASH-1 was freight delivery of trial materials (86.0 tonnes, 48% of total emissions), whereas the largest contributor in CRASH-2 was energy use by the trial coordination centre (54.6 tonnes, 30% of total emissions).
conclusionsFaster patient recruitment in the CRASH-2 trial largely accounted for its greatly increased carbon efficiency in terms of emissions per randomized patient. Lighter trial materials and web-based data entry also contributed to the overall lower carbon emissions in CRASH-2 as compared to CRASH-1. TRIAL REGISTRATION NUMBERS: CRASH-1: ISRCTN74459797CRASH-2: ISRCTN86750102.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.